TheWEL courses - David Reilly

[Hutan]

There are a range of courses branded under the TheWEL banner. David Reilly, a Glasgow doctor, is the developer of the courses.

My local health authority in New Zealand seems to be considering offering TheWEL courses for people with chronic illnesses specifically including ME/CFS. A person from Scotland has been brought here to present to health professionals to gauge interest and it seems to have gone down well. I am assured that the course will aim to 'help people cope' rather than cure them.

However, I've just spent a few hours listening to sessions and talks provided by Reilly online and I found it a bit disquieting.
http://thewel.org/theWEL/1__Foundations.html
http://thewel.org/theWEL/Videos.html

Reilly had CFS for a few years, but recovered. He seems to believe that the mind is powerful and there's a good chance we could become well if we want to. There are two recorded sessions available online that were delivered to a group of people with CFS. In them, he mentions that the MEA gives a falsely negative idea about the possibility of recovery. There is a bit about eating for health, and a bit about meditation. But, mostly, it's about how current medical practice isn't fixing people and so things need to be done a new way. Which, as far as I can see, seems to be about patients thinking more positively and taking charge of our own lives. I felt that there was a suggestion of 'if you aren't getting better, you aren't trying hard enough' underneath the friendly Billy Connolly-accented chat.

Some of what he says makes sense, which makes it all the harder to argue against the whole package. And I'm sure his ideas can help some people with illnesses like Type 2 diabetes, where changes in eating and exercise and good self-care may lead to real health improvements. (Although I'm not sure that the ideas are so ground breaking that we couldn't find an unbranded local speaker for that).

Has anyone had experience with TheWEL courses, or with making the case for scarce health funds not be used on such courses for people with ME/CFS?

 

[Wonko]

No but this

and there's a good chance we could become well if we want to.

tells me enough to totally disregard TheWEL and it's philosophy.

Once I read that I don't need to know any more.

It's flimflam.

 

[Trish]

I started watching the first video you linked and got bored very quickly. I found his patronising manner and waffle intensely irritating.

So I skipped to the last few minutes where he openly dismisses all the medical and alt med treatments which he describes as mechanistic tools including double blind trials, and says we need to turn to the other side of our selves - compassion, etc, to enable real change. Or words to that effect.

Not for me thank you!

 

[fivetowns]

The website doesn't inspire any confidence in the course (but the new age drivel is quite entertaining). Here are some extracts for anyone that doesn't want to waste time on the website:

Following a new map of health, people learn to move themselves in the opposite direction of today’s epidemics of long-term conditions. This impact is founded on activation of self-sustaining self-care, that in turn taps the well of our innate strengths for healing, health and happiness.

TheWEL was launched in 2004 as a direct modelling of the lessons learned from this ‘Healing Shift Enquiry’ and the principles of therapeutic encounter. It is not a ‘self-help, self-management course’, it is a method to effect deep change

He even mentions Psychoneuroimmunology:

Over years, a field study with people who had experienced healing changes and recovery was blended with background study and research of areas like the self-healing response, mind-body factors, stand psychoneuroimmunology

(I think stand is a typo for and)

Also the website looks like it was designed in the 1990's by some new age doomsday cult although strangely that's making me feel nostalgic for the old modem dial up sounds.

 

[NelliePledge]

Anything worse than someone who tries to make money off “being superior enough” to “recover” oh yes a dr who is a superhuman

Wow that website really is rubbish spelling mistakes right through to having light text on dark background to make it hard for people with visual impairments. And the language is totally psych-hippy man. Content is crap as well I mean based on 93% approval 3 weeks after the course this is something we should all rush out and do........

Sorry Kiwis somebody over there has lost the plot for picking up on this - I call TRIPE. It’s not even professional tripe.

 

[DokaGirl]

Just looking at the highlights from @fivetowns, the terms strung together look just as that - just words strung together - ie. in a song, or a poem, sounds high falutin' on the surface, but not so much underneath.

Seems very much like, or exactly like the attitude " If you really wanted to get better you would", and "If you don't get better, it's your fault."

 

[DokaGirl]

@NelliePledge's comments made me think of reformed smokers, or in this case, reformed cfs'ers. " I was bad, now I'm reformed". Holey, moley, cast out the you know who!

 

[Hutan]

Reilly makes a big deal of the fact that an injected placebo resulted in the same release of dopamine in Parkinsons patients as a drug that was being tested. This he sees as evidence that the mind is powerful and can heal us.

If the Parkinsons patients had learned that injections of drugs led to loss of tremors, I guess that there might be a dopamine release as a sort of Pavlovian response. There was a study that found that the placebo response only worked in patients who had received Parkinsons drugs previously, which supports that idea. How long the placebo response might be, or how strong relative to an effective drug, I don't know.

I'll have to look into it a bit more. Anyone know more about the placebo response in Parkinsons?

 

[Wonko]

...or he's a muppet and the placebo wasn't, it was active in terms of parkinson's.

Wouldn't be the first time t's happened - using sugar pills as placebo in a trial for diabetes drugs for example. (May be urban legend, I have no links and am too fried, it's too early, to hunt any down, but I remember it being discussed somewhere. It is the sort of stupid, mindless thing they do.)

 

[James Morris-Lent]

I was pretty much a paragon of mental-health and taking-care-of-oneself and I still got the disease. All this you-fix-yourself horseshit has always been laughable to me.

My question would be, who in New Zealand is trying to profit from the sale of this... stuff?



Also, the webpage looks like cringey e-mail/facebook memes, so at least there's that.

 

[Wonko]

Also, the webpage looks like cringey e-mail/facebook memes, so at least there's that.

I don't think I've seen a website that bad since the early 90's. And that's without taking into account its suitability for people with visual and cognitive issues.

Pathetic - a 10 year old could do a better job.

It's a real achievement for an adult to make a website so bad and effectively unuseable by accident, therefore I conclude it must be by design, deliberate.

They is trying to break our brains.

 

[Trish]

This from the website:

TheWEL Programme was created by Dr David Reilly.
Its evaluation and wider sharing has been supported by TheWEL Charity and its donors - including the Scottish Government.
Please contact David if you wish to reproduce any of TheWEL materials

It is concerning that what is apparently a one man money making organisation that sells false hope and creepy quack therapy is both a charity and funded by the Scottish Government.

Worth looking in to how it comes to be a charity, what his 'Dr.' title signifies, and why the Scottish government are donors.

 

[Trish]

No sooner said than done:

Dr David Reilly MBChB, FRCP, MRCGP, Honorary DSc (University of Westminster). He is currently Director of TheWEL Programmes, and The Healing Shift Enquiry, Founder and Director of TheWEL Charity.

Until 2016 he was a Consultant Physician in The NHS for Centre for Integrative Care in Glasgow; and Greater Glasgow & Clyde Health Board’s Lead Clinician for people with CFS/ME.

He is still an Honorary Senior Lecturer in Medicine, Glasgow University, and Visiting Professor of Medicine, University of Maryland, and visiting faculty for the Weill Cornel Univeristy in Doha, Qatar.

He is a former visiting faculty member at Harvard Medical School, USA; he was The Scottish Government’s first National Clinical Lead for Integrative Care.

My bolding.

More at link:

http://www.davidreilly.net/HealingShift/Bio_&_Contact.html

Edit to add: He's into homeopathy too.

 

[NelliePledge]

The healing shift. Think we’ve spotted another typo

 

[Wonko]

The healing shift. Think we’ve spotted another typo

Are you sure, a lot of religions make people wear simple dresses, shifts, for initiation ceremonies.

 

[shak8]

The healing shift. Think we’ve spotted another typo

He needs a major developmental edit, proofreading, etc.

My personal opinion about docs who become "healers" is that they don't want to work as hard as docs do in practice. Notice how he felt better having left the NHS.
It's a much easier lifestyle to not do the science and art of medicine, but rather just play whimsical commonsense.

 

[Wonko]

what he needs is a new 'product', preferably one that works.

and maybe one or 2 less heads

 

[Ravn]

My local health authority in New Zealand seems to be considering offering TheWEL courses for people with chronic illnesses

First thought upon reading a DHB (I assume?) is considering this: they haven't been making their targets on diabetes or reduced hospital admissions or whatever, got desperate, and now they've been taken in by the promise of a cheap 'solution'. Which will turn out to be less cost-effective than they had hoped, or in plain English: a waste of money.

Haven't watched the video but based on others' comments maybe ask a few questions (reformulate to sound less snarky )

assured that the course will aim to 'help people cope' rather than cure them

What evidence is there that getting patients to watch these videos will improve outcomes/coping? Is this evidence, if any exists, based on questionnaires about good intentions about healthy lifestyle, administered 1 hour after the video? Or is it based on objective markers 1 year down the track?
What evidence is there for the videos improving outcomes/coping for specific illness A, specific illness B, etc.?

mostly, it's about how current medical practice isn't fixing people

What evidence is there that coaching patients to mistrust the medical system will improve outcomes/coping? Or is that a sneaky strategy to stop patients going to see doctors?

He seems to believe that the mind is powerful and there's a good chance we could become well if we want to.

They need to understand that the line of "you could be better if only you wanted to" is patient blaming and carries the risk of significant harm (I'm thinking of that Norwegian teen who attempted suicide after failing to improve on LP).

Some of what he says makes sense, which makes it all the harder to argue against the whole package.

That is a typical strategy of quackery. Say something sensible and scientifically proven first. This gains trust. After that people will be much more likely to swallow any illogical nonsense you may wish to sell them.

Reilly makes a big deal of the fact that an injected placebo resulted in the same release of dopamine in Parkinsons patients as a drug that was being tested. This he sees as evidence that the mind is powerful and can heal us.

I don't know about the Parkinson's placebo effect but recall reading a similar story about a pain placebo effect: that it can work on a subconscious level (i.e. doesn't require conscious belief), that the body (not the 'mind') 'remembers' a pill having previously triggered the body's own pain-reduction pathways and now reacts to an inert pill with upregulating the same endogenous pathways again. Sorry, can't find the link but I remember asking myself these questions:

If this is indeed a true and replicable effect - I've become very suspicious in my old age, haven't I? - how long does this effect last? After all, many medicines, including pain medicines, loose their effectiveness over time so why would a placebo effect last better? Also, would the body eventually 'realise' the new pill doesn't do anything after all and stop reacting to it?

What about patients who have never experienced relief from a pain killer? Presumably for them this type of placebo effect couldn't work. Cue problem for all illnesses where an effective treatment doesn't yet exist.

My impression is the placebo effect research is at a similar stage to Central Sensitisation: There is some evidence the phenomenon may be at play to some degree in some very specific situations. Some people then get carried away and interpret this as meaning it is proven to apply in all situations - without any evidence of that whatsoever.

At any rate Reilly contradicts himself if on the one hand he claims placebo works on the physiological level, no belief required, and on the other hand argues the mind over matter line.

 

[Trish]

Surely if that placebo effect in Parkinson's was real objective and lasting it would be a recognised treatment. Sounds like a temporary subjective effect to me, like that asthma study often quoted where the placebo inhaler gave subjective improvement but not objective change.

 

[Hutan]

a DHB (I assume?) is considering this

Yep, a District Health Board. I only have this from a person who attended the pilot program that was run to gauge interest from health professionals. It may be that someone further up in the organisation will think harder before approving funding courses for patients.

What evidence is there that getting patients to watch these videos will improve outcomes/coping?

I believe the plan is to actually provide courses, rather than have people watch videos. The website does suggest in a few places that there is evidence. I'd have to look harder to be sure exactly what is there (I agree @Wonko, the website is bad). I expect it's based on how people fill out the questionnaires at the end of the course and/or is subjective.

They need to understand that the line of "you could be better if only you wanted to" is patient blaming and carries the risk of significant harm (I'm thinking of that Norwegian teen who attempted suicide after failing to improve on LP).

Yes, indeed. After watching those videos, and even though I could see the techniques Reilly used, I have felt quite demoralised ( a niggling feeling of 'maybe I could try harder to be well?' even though I know I could not have, and also feeling sad that people who are supposed to be helping can't see this stuff for what it is).

At one point in a video Reilly talks about drawing. After having got everyone saying that they can't draw (even a person who initially said that they could), he muses on what this pessimistic belief about drawing talents might be indicating about the group. He then asks who would like to be able to draw, and everyone obligingly says, 'yeah, that would be good'. And then he asks, 'but what's holding you back?'. And people say 'fear of failure', 'too much effort', 'don't want to be able to draw that much'. He then shows evidence that people were taught to draw in 5 days. He asks, 'knowing that it's quite easy, does that make you more inclined to try?'. It's a not very subtle extended metaphor for getting better.

Surely if that placebo effect in Parkinson's was real objective and lasting it would be a recognised treatment.

Yes, surely.